paramedicmike

Looking for a new heart?? And he shot a lawyer? What was he thinking??? :shock: Oops! Was that out loud? My bad.

Is that certified or certifiable? I've had many people tell me I'm certifiable. Fortunately, I manage to keep a step or two ahead of those guys who want me to try on this coat with really long sleeves! :shock: I am, as indicated by my screen name, both certified and licensed (depending on which state/commonwealth you want) as a paramedic. Registry, licensed in one state, certified in two commonwealths. -be safe.

Any particular agency in mind? There are quite a few in NYC. -be safe.

Be careful when you Google. There are many EMS organizations in Washington who call themselves Medic1. It's all a play off the original which is King County Medic One. When you Google it, make sure you include the "King County" as part of your search criteria. King County Medic One has one of the best EMS systems in the US. They have a very progressive and involved medical director. They are ALS only which means their paramedics only do ALS calls. If it's BLS the local BLS truck takes the call. While their system won't work everywhere, I think they do an awful lot from which the rest of us could learn. Hope that helps. -be safe.

I'd like to see him argue against gun control after this. He can't even use the "gun control is hitting at what you're aiming" line anymore. Not taking a stand on gun control. Just making an observation. -be safe.

Further, you were advocating the use of a hot response to the hospital and you don't even know what you're transporting! How scary is that?! :shock: There are two types of students. There are students who ask questions in the hope that everything will be explained to them. Then there are students who make the effort to look up information first and then ask questions on concepts that aren't yet understood or are confusing. One is certainly more well received than the other. Any type of search feature is your friend. It usually helps to check before asking questions. -be safe.

I think this article discusses an important aspect of EMS. However, I don't like the premise on which it was written. From the article: It sounds to me like the author is maligning the very people for whom she writes. Or she's misinformed at best. Why are EMS providers deciding that transport is not needed? Further, anyone who would *encourage* a patient to sign a refusal shouldn't be working in EMS to begin with. Refusals are a touchy situation to start. Any refusal taken should not be taken lightly. All the paperwork should be filled out. Documentation of a refusal should be even more detailed than a normal PCR might otherwise be. We should not be deciding someone doesn't need transport. Further, we shouldn't be encouraging refusals. If you're going to take a refusal, make sure that everyone knows the potential for harm by not seeking care. And do a complete and thorough documentation of the call. I agree with Rid, too. Damned if you do. Damned if you don't. There's so much potential for harm to come out of not transporting someone. I realize we can't force them. But it's just so much easier if they go with us than if we let them stay home. -be safe.

To go further than what Dust noted (in my opinion correctly), if you or your partner present yourself as a less than effective communicator (whether in speech, writing or both), do you really think the doc is going to approve requests for orders when you call? The doc won't deny the request for orders simply because s/he doesn't think the request is appropriate. If the doc thinks you're a bumbling, uneducated idiot, why should you be trusted? And if you present yourself in a manner such that you stutter and bumble your way through a report and follow it up with a poorly written PCR (complete with spelling and grammatical mistakes) then you've demonstrated yourself not to be worthy of the trust with regards to extra patient care. And in the end, it's not the doc who suffers. It's the patient. Patient care suffers because you've demonstrated yourself, through your presentation in person and in writing, incapable of the trust to properly handle the care of the patient outside the realm of protocol. With that, you prevent the rest of us from being able to provide prudent care because now the doc thinks the rest of us are just as bumbling as you. And it's not the doc's fault. That comes back to you. Present yourself as an idiot and it's only the patient who suffers. Not the doc. You do to the extent that people think you're an uneducated buffoon. But ultimately it's the patient who gets less than reasonable care simply because your professional image presents someone who isn't trustworthy of the responsibility of patient care. Which makes you a taxi driver. Which makes the rest of us look bad. See the circle that's forming? Do us all a favor. Speak well. Write well. It'll help you and your patient in the long run. -be safe.

I do QA at work. I have returned, and will continue to return, PCRs with multiple spelling/grammatical errors. It is something that bugs me to no end. It gives the impression of an uneducated nimrod (sometimes not far from the truth) and puts the provider, and ultimately the service, in a bad way when that chart is presented in court. And the last thing I want is to be associated with some dumb ass who's too lazy to spell/grammar check the PCR being written for errors. Not because it makes them look bad. They can do that all on their own. It's because it makes *ME* look bad. If I'm going to be regarded in a negative light, let it be for something I did. Not something my lazy coworkers did. In an online forum I can see mistakes here and there. Free thinking and typing can lead to errors. I know I've missed a letter here and there, too. But I will agree with Dust that there's no excuse for it as there is a spell check feature on this site. (Spell checked for your convenience. )

"What do you mean I can't debate this (insert topic/procedure/drug administration). I've been *TRAINED* how to do it. Therefor, I'm qualified to discuss it in great detail!" Puh-lease! -be safe.

I'm going to disagree slightly with medic001918's post. Lead II does nothing more than tell you rate and rhythm. That's it. It is commonly used to see what's going on but it doesn't tell you anything other than how fast and the origin of the impulse. If you want to see what's really happening with the heart, you need a 12 lead (or, for a more complete diagnostic view, go for a 15 lead). The more you can see the better idea you will have as to what's going on in the heart. If you don't have access to a 12 lead you can do what's called a modified 12 lead. Place your monitor in lead III. Take the red lead and move it to the various positions on the chest where leads would go if you had the 12 lead capability (R then L 4th intercostal space etc...). Make sure you label each one so you know what you're looking at later. This can help provide a better picture with a three lead monitor without the enhancement of 12 lead capabilities. To answer your question directly, yes. You should be flipping through all three lead readings. If you think you need a better view of what's going on, obtain a 12 lead. If you don't have 12 lead capabilities, use the above to help obtain a modified 12 lead. Hope this helps. -be safe.

Pennsylvania has as well. While my squad doesn't currently carry it we are in talks with our MD to add it to what we already carry. -be safe.

Placing an endotracheal (ET) tube is not a matter of "hit or miss". It is a process of directly visualizing the epiglottic opening and watching as you actually place the ET tube through the vocal cords and into the trachea itself. Once in place with the cuff inflated and the tube secured you have direct access through the tube into the trachea and lungs. Placing a combitube is a matter of opening the patients mouth and sliding it in (blind insertion). Once in place and secured, there is still the risk of losing the airway due to some form of tracheal or epiglottic injury as air from ventilations still has to pass these anatomic structures. It is not as direct a route to the trachea and the lungs as is the ET tube. Since it's not as direct a route, the airway is not as secure as it might possibly be with an ET tube in place. Further, a properly placed and secured ET tube offers access to certain medications in certain situations. While this isn't strongly recommended, it is still an option. You just can't push medications down a combitube. Lastly, please do a search on the subject. There have been many discussions here regarding this very topic. Some of these discussions have gone into quite a bit of depth regarding many aspects of the use of either airway management device. The search function is your friend. Please use it accordingly. -be safe.

We obviously don't because I have no idea to what you're referring. Can you help me out with some info on what you mean? -be safe.

You know, you'll forgive my being blunt, but this sounds like a relationship that has already fallen apart. It's just that noone's told you yet. Like Rid said, you did nothing wrong. He can't turn this around on you because you've done nothing wrong. If he tries to pin this on you, you have the advantage of knowing he's going to try to plus he made the choice to fool around. This may just be the pessimist in me, but it sounds like he's already gone. He's actively cheating on you. He's having virutal sex. The mere fact that you know he's going to be defensive and try to say it's your fault indicates he's guilty. This sounds like he's already checked out and just hasn't had the common decency to tell you. Please follow up with some professional (marriage) counseling. You can only benefit from it. Be strong. You can and will get through this. It's not your fault. You did nothing wrong. He's the scumbag. You are not! Good luck. -be safe.

The thing weighs what? 120 pounds? Is the lift feature going to be offset by the back injuries of just trying to move the thing into and out of residences? I don't know. Just wondering out loud. Nate and anyone else who works with this, how easy is it to maneuver once it's out of the truck? Into and out of a residence? It the extra weight worth not having to lift anymore? Just curious. That's all. -be safe.

I read this today and thought, "this sounds awfully familiar." http://www.breitbart.com/news/2006/02/02/D8FH2EU01.html I wonder how he got to his jumping point? And I never thought about it, but how did he get outside? I can't imagine the windows open that far if they open at all. -be safe.

I have a lego ambulance that a GF bought for me. That doesn't count, does it? -be safe.

Anne Arundel or Queen Anne?

Free falling is the fun part. It's landing that hurts! -be safe.

Ditto. It should have become apparant early on in your education that there could be circumstances that might conflict with whatever religious views you might hold. If you had a problem with it then, it's not going to get any easier. Find a new job. Health care whether it be on the street or in a hospital is no place to try and make a statement regarding whatever religious beliefs you hold. Yummymedic, Yes, there is a procedure known as either a female circumcision or female genital cutting. Commonly seen in parts of Africa and the Middle East, it's usually argued by those who endorse it as a religious practice. Worldwide, the position is increasingly becoming one of barbaric abuse and a violation of womens rights. Google it. You'll get all sorts of info. -be safe.

That's because there is none. Take the three seconds to say "Hi. I'm skinut2234." Then, depending on how they present, ask their name or ask what's wrong. It gets you off to a better start with the patient. It also provides you with a function of your assessment. If they can talk back that tells you a lot. If they just give you that 1000 yard stare and keep forcing themselves to breathe that tells you a lot, too. The only time when this might prove to be a waste of time is if they're unconsious or dead in front of you. I would rather arrive on scene and have you tell me "This is Mr. Jones. He's been having trouble breathing for an hour. We just got here and that's all I have." than arrive and have you provide me with a rushed set of vitals but not be able to tell me the patient's name or what's wrong. I'm with Rid. Talk to this medic. Be professional. Stand your ground and don't back down. By posting this and asking, you know what's right. Maintain this position. Don't become like your partner. That does no one any good at all. Good luck. -be safe.

You haven't said why you're so intent on working. So why are you so intent on working while in school? I can gaurantee you that as a freshman you are going to be quite surprised by how much work you're going to have to do as classes continue. And don't expect to be able to do homework while working. Not only will you not have time but the bosses tend to look down on that kind of thing. If you need to maintain a 3.7 GPA then you should probably hold off until everything else falls into place school wise. Then, once you have an idea of how much work school is going to require and what kind of down time you'll have you can better budget for some sort of part time only job. You need to decide which is more important. School or work. If work is more important then by all means, drop out and concentrate on a dead end job. And yes, I have been to college. I have faced the same decision you are right now. I learned the hard way that school needs to come first. Once I learned my lesson, the rest of school became much more easy with which to deal. Good luck. -be safe.

School first. School second. School third. Taking care of you comes in fourth, fifth and sixth. Then school for eight, ninth and tenth spots. Work comes in somewhere down around 412 or something. An ER tech job is a short term thing. An education will last you a lifetime and will get you further than this job ever will. If you absolutely must work, find something that's easy on your schedule and will not take time from school, homework or the down time that you'll need to decompress (just as important!). If that means something other than working as an ER tech, well, then do something else. That's great you want to learn all this stuff the job can teach you. But that's not going to get you anywhere for the long haul. Concentrate on school first and foremost. Worry about the other stuff later. Did I happen to mention that school should be your first priority? -be safe.

Reminds me of the Simpsons episode where Homer buys an old Caddy ambulance and fixes it up. He's driving some OD/attempted suicide to the hospital, siren wailing, window down, arm draped over the back seat and is asking the patient questions. When there's no response Homer says, "Hmmm...not the talkative type, eh?" and then screams on down the road. Mmmmmmm....super donut.....Mmmmmmmm....beer. -be safe.